Talk of The Villages Florida

Talk of The Villages Florida (https://www.talkofthevillages.com/forums/)
-   Medical and Health Discussion (https://www.talkofthevillages.com/forums/medical-health-discussion-94/)
-   -   Insurance change unaccepted by The Villages Health. (https://www.talkofthevillages.com/forums/medical-health-discussion-94/insurance-change-unaccepted-villages-health-338114/)

bwasman 01-11-2023 03:57 PM

Insurance change unaccepted by The Villages Health.
 
The Teachers Retirement System in Illinois has replaced United Health Care Medicare Advantage PPO with a new policy contracted with Aetna Medicare Advantage PPO. Use of the new policy has been denied by The Villages Health System and anyone using it has to find new Dr.'s outside The Villages system resulting in delayed care and far out appointments. No reason is given by The Villages System other than a flat No to Aetna personell.

Babubhat 01-11-2023 04:17 PM

Bad luck. A victim of Teachers cost cutting likely.

Davonu 01-11-2023 04:18 PM

Amazing. My employer did the same…with Aetna also. After one year, we went back to UHC on our own and are very happy. We even save money on premiums every month with very small increases in deductibles. :)

Altavia 01-11-2023 04:21 PM

And that's why you want to stay with standard Medicare if you can afford it...

JoMar 01-11-2023 04:25 PM

Quote:

Originally Posted by bwasman (Post 2175000)
The Teachers Retirement System in Illinois has replaced United Health Care Medicare Advantage PPO with a new policy contracted with Aetna Medicare Advantage PPO. Use of the new policy has been denied by The Villages Health System and anyone using it has to find new Dr.'s outside The Villages system resulting in delayed care and far out appointments. No reason is given by The Villages System other than a flat No to Aetna personell.

The Villages Health dropped Aetna plans years ago.....we were one of those that was dropped. Reasons speculated on by residents is that Aetna's payments were slow and always contested, the profit margin was adversely impacted by Aetna and procedures were routinely questioned. Don't know if true or not but The Villages Health is a business so they make their decisions based on business models. We stayed in the system and haven't regretted it.

Carla B 01-11-2023 04:55 PM

My daughter spent five years in her job battling against Aetna and their refusual to pay claims submitted by her employer, a hospital system. She said they have doctors and lawyers lined up to pick apart contracts and find reasons not to pay claims. And now, the irony is that this year her same employer has contracted to buy health insurance from Aetna.

BrianL99 01-11-2023 05:43 PM

Quote:

Originally Posted by bwasman (Post 2175000)
The Teachers Retirement System in Illinois has replaced United Health Care Medicare Advantage PPO with a new policy contracted with Aetna Medicare Advantage PPO. Use of the new policy has been denied by The Villages Health System and anyone using it has to find new Dr.'s outside The Villages system resulting in delayed care and far out appointments. No reason is given by The Villages System other than a flat No to Aetna personell.

This what they accept and they've always been clear & upfront about it.

https://thevillageshealth.com/wp-con...-Update-v4.pdf

GaryKoca 01-12-2023 07:09 AM

Even with standard Medicare, you probably still need some type of supplemental insurance. We have basic Federal Employees Health Benefits, with pretty much covers everything Medicare does not. But you have to be a retired Federal employee to get that insurance.

Ritagoyer 01-12-2023 07:37 AM

Quote:

Originally Posted by Altavia (Post 2175005)
And that's why you want to stay with standard Medicare if you can afford it...

But they will run into the same problem they do not except Medicare

nob77@comcast.net 01-12-2023 07:47 AM

Quote:

Originally Posted by bwasman (Post 2175000)
The Teachers Retirement System in Illinois has replaced United Health Care Medicare Advantage PPO with a new policy contracted with Aetna Medicare Advantage PPO. Use of the new policy has been denied by The Villages Health System and anyone using it has to find new Dr.'s outside The Villages system resulting in delayed care and far out appointments. No reason is given by The Villages System other than a flat No to Aetna personell.

Simple. Aetna doesn’t pay(enough)

BrianL99 01-12-2023 07:54 AM

1 Attachment(s)
Quote:

Originally Posted by Ritagoyer (Post 2175085)
But they will run into the same problem they do not except Medicare


Yes they do.

jarodrig 01-12-2023 08:02 AM

Quote:

Originally Posted by BrianL99 (Post 2175094)
Yes they do.

The discussion is about PRIMARY CARE doctors.

Specialty Care doctors are not primary care doctors.

Once again , The Villages Health DOES NOT accept standard Medicare ……

My wife and I were kicked out upon reaching 65 and going on Medicare…..

retiredguy123 01-12-2023 08:11 AM

Quote:

Originally Posted by GaryKoca (Post 2175078)
Even with standard Medicare, you probably still need some type of supplemental insurance. We have basic Federal Employees Health Benefits, with pretty much covers everything Medicare does not. But you have to be a retired Federal employee to get that insurance.

I am a retired Federal employee and I save thousands of dollars by having the standard Blue Cross plan, but do not have Medicare Part B. The Blue Cross plan covers almost everything I need, and it has a low catastrophic limit of $6,000 per year. The Medicare premiums are too high, especially if you are subject to IRMAA.

Babubhat 01-12-2023 08:17 AM

Bottom line is employers get an incentive from the new insurance provider. When the contract is up they bid out the business to get another incentive. They have no interest in whether you like it or not.

asiebel 01-12-2023 08:20 AM

We have had to change not only primary care but eye Dr, pain management, and where we purchase medications. Hope it is a good company!


All times are GMT -5. The time now is 03:32 AM.

Powered by vBulletin® Version 3.8.11
Copyright ©2000 - 2024, vBulletin Solutions Inc.
Search Engine Optimisation provided by DragonByte SEO v2.0.32 (Pro) - vBulletin Mods & Addons Copyright © 2024 DragonByte Technologies Ltd.